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急诊钝性腹部创伤患者对比增强超声的诊断准确性:系统评价和荟萃分析。

Diagnostic accuracy of contrast enhanced ultrasound in patients with blunt abdominal trauma presenting to the emergency department: a systematic review and meta-analysis.

机构信息

Department of emergency medicine, Sir Run-Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310016, China.

出版信息

Sci Rep. 2017 Jun 30;7(1):4446. doi: 10.1038/s41598-017-04779-2.

Abstract

We aimed to investigate the diagnostic accuracy of contrast-enhanced ultrasound (CEUS) in evaluating blunt abdominal trauma for patients presenting to the emergency department. Electronic search of Scopus and Pubmed was performed from inception to September 2016. Human studies investigating the diagnostic accuracy of CEUS in identifying abdominal solid organ injuries were included. Risk of bias was assessed using the QUADAS tool. A total of 10 studies were included in the study and 9 of them were included for meta-analysis. The log(DOR) values ranged from 3.80 (95% CI: 2.81-4.79) to 8.52 (95% CI: 4.58-12.47) in component studies. The combined log(DOR) was 6.56 (95% CI: 5.66-7.45). The Cochran's Q was 11.265 (p = 0.793 with 16 degrees of freedom), and the Higgins' I was 0%. The CEUS had a sensitivity of 0.981 (95% CI: 0.868-0.950) and a false positive rate of 0.018 (95% CI: 0.010-0.032) for identifying parenchymal injuries, with an AUC of 0.984. CEUS performed at emergency department had good diagnostic accuracy in identifying abdominal solid organ injuries. CEUS can be recommended in monitoring solid organ injuries, especially for patients managed with non-operative strategy.

摘要

我们旨在探讨对比增强超声(CEUS)在评估因腹部钝伤就诊于急诊科的患者中的诊断准确性。电子检索 Scopus 和 Pubmed 数据库,检索时间截至 2016 年 9 月。纳入研究 CEUS 诊断腹部实质脏器损伤的准确性的人类研究。使用 QUADAS 工具评估偏倚风险。共有 10 项研究纳入本研究,其中 9 项进行了荟萃分析。在单项研究中,log(DOR)值范围为 3.80(95%CI:2.81-4.79)至 8.52(95%CI:4.58-12.47)。合并的 log(DOR)值为 6.56(95%CI:5.66-7.45)。Cochran's Q 为 11.265(p=0.793,自由度为 16),Higgins' I 为 0%。CEUS 对实质脏器损伤的敏感性为 0.981(95%CI:0.868-0.950),假阳性率为 0.018(95%CI:0.010-0.032),AUC 为 0.984。CEUS 在急诊科诊断腹部实质脏器损伤具有良好的诊断准确性。CEUS 可用于监测实质脏器损伤,特别是对接受非手术治疗策略的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18d5/5493732/51cc8293fa71/41598_2017_4779_Fig1_HTML.jpg

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